Provider Demographics
NPI:1871996488
Name:HILAIRE, ABDALLAH MYRTHE (MSOTR/L)
Entity type:Individual
Prefix:MRS
First Name:ABDALLAH
Middle Name:MYRTHE
Last Name:HILAIRE
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 PERSHING BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3424
Mailing Address - Country:US
Mailing Address - Phone:516-652-8559
Mailing Address - Fax:
Practice Address - Street 1:514 PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3424
Practice Address - Country:US
Practice Address - Phone:516-652-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-28
Last Update Date:2014-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014297225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist